Infant bed

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An infant bed, depicted with posts that present a strangulation hazard Crib (PSF).png
An infant bed, depicted with posts that present a strangulation hazard

An infant bed (commonly called a cot in British English, and, in American English, a crib, or far less commonly, stock) is a small bed especially for infants and very young children. Infant beds are a historically recent development intended to contain a child capable of standing. The cage-like design of infant beds restricts the child to the bed. Between one and two years of age, children are able to climb out and are moved to a toddler bed to prevent an injurious fall while escaping the bed.

Contents

Infant beds are more common in Western countries, employed by the majority of parents as an alternative to sharing a bed (co-sleeping).

History

Late-18th century Dutch painting of a baby in a crib 'Het welbewaakte kind' Rijksmuseum SK-A-2295.jpeg
Late-18th century Dutch painting of a baby in a crib

The name "crib" was used to describe a slatted, high-sided child's bed. [1] It derives from the Old English word "cribb" which means "manger" (food trough, referring to the shape of a bassinette) or stall (implying corralling the child).

It was not until the 19th century that infant beds developed from bassinettes, acquiring a role of keeping the child in their bed. The development of a distinction between infant beds and bassinettes was natural because it was "considered vital that the child's bed be raised off the ground." [1] This was due to a perception of noxious fumes below knee level, and explosive vapours near the ceiling, with good air in between. [1] Once children's beds were raised off the ground the role of the sides changed from a convenience to a safety feature.

It was recognised that once children learn to stand they may be able to get out of a bed with low sides. According to an expert of the time, infant beds were used once the child was 12 months old. Often one side was hinged to open the enclosure, a function fulfilled in modern infant beds with a dropside. With the hinge side lowered, the bed could be moved on casters, and they could be moved right up to the carer's bed when needed. [1]

Cradles in a museum Berco (1.3), Acervo do Museu do Colono (Santa Leopoldina).jpg
Cradles in a museum

Iron beds were developed in 17th century Italy to address concerns about bed bug infestation and moths. [2] This new application was quickly extended to children's beds - a rockable iron bassinette (with spear-like corner posts) has been dated to 1620–1640. [2] Proponents promoted the supposed health benefits of iron beds. Infant beds constructed from metal became popular during the later half of the 19th century. [1] Infant beds (and bassinettes) constructed from iron with mesh or chain sides were common. Childcare experts gave iron beds their approval because it was hygienic material (compared with wood) and could not "harbour vermin", [1] of which bed bug infestation, lice and moths were cited concerns. [2] Commonly painted with a white vitreous enamel, later manufacturers working with wood continued to paint in the now traditional white; unfortunately this was often lead paint, and children were notorious for chewing and sucking the sweet surface.

Since 1938, babies in Finland have slept in cardboard boxes with a mattress in the bottom, which are distributed to expectant mothers as a "maternity package" containing baby supplies. [3]

Design

Standards

Standards specify acceptable and hazardous gaps in infant beds Infant furniture acceptable gaps.svg
Standards specify acceptable and hazardous gaps in infant beds

As an example of improving safety of infant bed designs, the U.S. Consumer Product Safety Commission has set standards for infant beds sold since 1973. Since this time U.S. annual deaths attributed to infant beds reducing from approximately 200 to approximately 50, [4] and injury rates now at approximately 8,000 per year. [5] Many of these injuries are attributed to the 25 million infant beds manufactured prior to the progressively refined safety standards, yet still in use. [6]

Infant beds are designed to restrict the baby to the bed. The sides are too high for a baby to climb and provide no footholds. Technical standards for infant beds include considerations such as the materials used and preventing hand and head entrapment. Standards for infant beds have been specified in Australia and New Zealand, [7] Europe, [8] the United States [9] and internationally. [10] Design standards all identify and address four broad hazards:

Falls
To prevent injuries such as concussion and bone fractures from falls when trying to climb out, footholds are not permitted. Minimum cot side heights are defined for various mattress positions.
Strangulation
Infants can become trapped and strangled if their clothing gets caught on parts of a cot that stick out, or if their head becomes trapped between gaps. Neither gaps large enough for a child's head nor protrusions are permitted.
Suffocation
Babies lack the motor skills or strength to turn their heads should they roll into something that obstructs their breathing. They can become trapped and suffocate if they fall into gaps created by ill-fitting or additional mattresses. Babies can also suffocate if the mattress is too soft.
Entrapment
Infants can suffer injuries to their arms and legs if they become trapped between gaps. Gaps small enough for a limb to become trapped are not permitted.

Some older cribs contained a drop gate (or drop side), a side which lowers to ease the process of putting the child into the bed, but can be raised again to restore the integrity of the enclosure. However, assembly problems and malfunctioning hardware on drop gates can cause the formation of gaps, which have been attributed to infant deaths and other major injuries. In June 2011, the United States implemented new safety standards requiring all infant beds manufactured and sold in the country to have fixed sides. [11] In June 2016, Canada implemented a similar ban on the sale, importation, or distribution of any infant bed containing drop sides effective December 29, 2016. [12]

Variations

Infant beds can be stationary or portable (portacots, portacribs or folding infant beds). In their portable form the beds generally do not feature a dropside, and portability factors are emphasised. Portacots are often made from plastics, are often smaller and fold into a compact package. Rather than bars, they will have breathable mesh sides with an aperture too small for any finger to fit into (less than 5mm by the standards). Standards for folding infant beds exist for Australia and New Zealand, [13] Europe [8] and international [10] (adopted by various organisations including the American National Standards Institute).

Convertible cribs or convertible cots that can be converted into a standard sized bed as the child grows larger have become increasingly popular due to a longer useful life for the furniture. By removing both sides it becomes a toddler bed with unusually high head and foot boards, or removing just one side it becomes a daybed.

Baby cradle Baby Cradle.jpg
Baby cradle

Although in the U.S. there is a standard size for an infant bed (~71 cm x ~133 cm), 12% of the 2.4 million infant beds sold annually are not of this size; "mini cribs" are an example of this. [4] The "mini crib" is an umbrella term that covers all cots smaller than the standard size. [14] It means that travel cribs and many play yards can also be called mini cribs. This said, people often use the term for small baby beds with hard sides.

Larger infant beds are manufactured, generally for hospital use or for those with special needs. They may include a top, generally made of plastic or metal, to prevent a child from climbing out.

A cradle is an infant bed which rocks but is non-mobile. [15] It is distinct from a typical bassinet which is a basket-like container on free-standing legs with wheels. A carbonized cradle was found in the remains of Herculaneum left from the destruction of the city by the eruption of Mount Vesuvius in 79 CE. [16]

Use

An infant bed is typically used after it is no longer safe to leave the baby in a bassinet. They have a lower center of gravity, more mass, a broader base of support and can hold a larger baby than a bassinet. Infant beds are more stable than bassinets and as such become desirable when a baby can roll, transferring inertia with their actions; a bassinet may tip, an infant bed will not without concerted effort. Around two or three years of age children are able to defeat their confinement and should be moved to a toddler bed to prevent an injurious fall while escaping their bed (falls account for 66% of emergency room admissions due to infant beds in the United States. [5] ).

A baby lying on an elevated mattress in an infant bed with traditional crib bumpers Baby.jpg
A baby lying on an elevated mattress in an infant bed with traditional crib bumpers

Placing a child into an infant bed can put strain on a caretaker's back as they typically have a mass between 11.8 kilograms (26 lb) [17] and 16.8 kilograms (37 lb) [18] at 36 months of age. To reduce the strain on those operating an infant bed, many infant beds feature:

The American Academy of Pediatrics recommends that infants under 12 months share a room (but not a bed) with their parents, as this has shown to be protective against sudden infant death syndrome (SIDS). Other sleep environment factors include supine positioning (back sleeping), use of a firm sleep surface, breastfeeding, consideration of a pacifier (dummy), and avoidance of soft bedding, overheating, and exposure to tobacco smoke. [19]

Accessories

A wooden cradle from India Indian cradle.jpg
A wooden cradle from India

Scientific research has shown that the mattress influences SIDS outcomes; a firm, clean and well-fitting mattress lowers SIDS risk. However, neither mattress materials [20] nor using a second-hand mattress [21] affect SIDS risk. It is common to place a waterproof membrane between the mattress and the bedding to prevent uncontained bed wetting from damaging the mattress. Bed sheets ought to fit the mattress tightly so that the child cannot become entangled and suffocate; a common safety recommendation is to short sheet the bed. [22]

Because of the pronounced risk of suffocation in very young children, and the danger of a fall from the bed for other children, the addition of anything other than sheets (including quilts, pillows and stuffed toys) into an infant bed is not recommended by health authorities. [23] A sleepsack can be used instead to keep the baby warm. Older children can use items such as pillows and toys to construct a platform to facilitate escape, defeating the major design criteria and endangering the child.

An infant bed with raised mattress, mobile and traditional crib bumpers (now considered dangerous) Krevetac22.JPG
An infant bed with raised mattress, mobile and traditional crib bumpers (now considered dangerous)

Bumpers (cushioning), also known as "rompers" in some regions, are marketed to keep children from bumping against the hard sides and hurting themselves or becoming entrapped between the crib slats. [19] A number of instances of SIDS have involved crib bumpers, and the American Academy of Pediatrics recommends against their use. [24] The Safe Sleep for Babies Act of 2021 banned the sale or manufacture of crib bumpers in the United States, along with infant beds inclined more than 10°.

Some toys are specifically intended for an infant bed. Mobiles are musical toys to soothe the baby to sleep, but should be removed before the child can stand (8 to 12 months of age). Mirrors are to keep the children entertained while awake in the bed.

With decreasing technology prices and increasing house sizes, [25] it has become increasingly common to have a baby monitor nearby so as to alert the caretaker when the child awakens. Without either professional endorsement or scientific evidence that they prevent SIDS, apnea monitors are available to alert the caregiver if the baby stops breathing. [26]

Breathable mattresses are now being recommended to provide safer infant sleep. [27] In the event an infant rolls over on their stomach they have a much better ability to breathe with a breathable mattress, compared to a closed surface mattress.

Manufacturers

All U.S. makers of infant cribs carry JPMA safety and quality certifications.

See also

Related Research Articles

<span class="mw-page-title-main">SIDS</span> Sudden unexplained death of a child of less than one year of age

Sudden infant death syndrome (SIDS), sometimes known as cot death, is the sudden unexplained death of a child of less than one year of age. Diagnosis requires that the death remain unexplained even after a thorough autopsy and detailed death scene investigation. SIDS usually occurs during sleep. Typically death occurs between the hours of midnight and 9:00 a.m. There is usually no noise or evidence of struggle. SIDS remains the leading cause of infant mortality in Western countries, constituting half of all post-neonatal deaths.

<span class="mw-page-title-main">Sleeping bag</span> Insulated covering for a person

A sleeping bag is an insulated covering for a person, essentially a lightweight quilt that can be closed with a zipper or similar means to form a tube, which functions as lightweight, portable bedding in situations where a person is sleeping outdoors. It is also commonly used indoors for people who do not have beds or at sleepovers. Its primary purpose is to provide warmth and thermal insulation through its synthetic or down insulation. It also typically has a water-resistant or water-repellent cover that protects, to some extent, against wind chill and light precipitation, but a tent is usually used in addition to a sleeping bag, as it performs those functions better. The bottom surface also provides some cushioning, but a sleeping pad or camp cot is usually used in addition to that purpose. The bottom surface of a sleeping bag may be moderately water repellent, but a plastic tarp or groundsheet is often used to protect against moist ground.

<span class="mw-page-title-main">Air mattress</span> Type of mattress

An air mattress is an inflatable mattress or sleeping pad.

Co-sleeping or bed sharing is a practice in which babies and young children sleep close to one or both parents, as opposed to in a separate room. Co-sleeping individuals sleep in sensory proximity to one another, where the individual senses the presence of others. This sensory proximity can either be triggered by touch, smell, taste, or noise. Therefore, the individuals can be a few centimeters away or on the other side of the room and still have an effect on the other. It is standard practice in many parts of the world, and is practiced by a significant minority in countries where cribs are also used.

<span class="mw-page-title-main">Bed</span> Piece of furniture used as a place to sleep or relax

A bed is an item of furniture that is used as a place to sleep, rest, and relax.

<span class="mw-page-title-main">Baby transport</span> Methods of transporting young children

Various methods of transport of children have been used in different cultures and times. These methods include baby carriages, infant car seats, portable bassinets (carrycots), strollers (pushchairs), slings, backpacks, baskets and bicycle carriers.

<span class="mw-page-title-main">Baby monitor</span> Radio system for remotely listening to a child

A baby monitor, also known as a baby alarm, is a radio system used to remotely listen to sounds made by an infant. An audio monitor consists of a transmitter unit, equipped with a microphone, placed near to the child. It transmits the sounds by radio waves to a receiver unit with a speaker carried by, or near to, the person caring for the infant. Some baby monitors provide two-way communication which allows the parent to speak back to the baby. Some allow music to be played to the child. A monitor with a video camera and receiver is often called a baby cam.

<span class="mw-page-title-main">Bassinet</span> Type of bed for the youngest infants

A bassinet, bassinette, or cradle is a bed specifically for babies from birth to about four months. Bassinets are generally designed to work with fixed legs or caster wheels, while cradles are generally designed to provide a rocking or gliding motion. Bassinets and cradles are distinguished from Moses baskets and carry cots, which are designed to be carried and sit directly on the floor or furniture. After four months, babies are often transferred to a crib or cot. In the United States, however, the bedside sleeper is the prevalent option, since they are generally bigger, recommended up to 6 months, and often used up to a year.

A toddler bed is a small bed designed for toddlers. A child grows capable of escaping an infant bed around one and a half or two years of age, at which they are often transitioned to a toddler bed. They become too large for a toddler bed between the ages of five and seven years, and will then transition to an ordinary bed.

<span class="mw-page-title-main">Safe to Sleep</span> Public health initiative to promote safe sleeping positions for babies

The Safe to Sleep campaign, formerly known as the Back to Sleep campaign, is an initiative backed by the US National Institute of Child Health and Human Development (NICHD) at the US National Institutes of Health to encourage parents to have their infants sleep on their backs to reduce the risk of Sudden Infant Death Syndrome, or SIDS. The target age group of the campaign is 0–1 years of age, because this is when babies are at the greatest risk of experiencing SIDS. Since "Safe to Sleep" was launched in 1994, the incidence of SIDS has declined by more than 50%. However, there has been a rise in infant sleep-related suffocation events. Consequently, the campaign has broadened its goal to focus on safe sleep conditions and further preventative measures.

<span class="mw-page-title-main">Orthopedic pillow</span>

An orthopedic pillow is a pillow designed to correct body positioning in bed or while lying on any other surface. Its design conforms to orthopedic guidelines to ensure the right placement and support of one or more specific parts of the body to provide safe and healthy rest to the sleeper.

<span class="mw-page-title-main">Travel cot</span> Foldable bed for use by a baby or young child

A travel cot is a bed for use by a baby or young child that collapses or folds into a bag for easy carriage. Travel cots are typically much lighter than a standard cot, with soft sides to provide comfort to the baby when sleeping.

Sleep training is a set of parental intervention techniques with the end goal of increasing nightly sleep in infants and young children, addressing “sleep concerns”, and decreasing nightime signalling. Although the diagnostic criteria for sleep issues in infants is rare and limited, sleep training is usually approached by parent(s) or caregivers self identifying supposed sleep issues.

Sudden unexplained death in childhood (SUDC) is the death of a child over the age of 12 months which remains unexplained after a thorough investigation and autopsy. There has not been enough research to identify risk factors, common characteristics, or prevention strategies for SUDC.

<span class="mw-page-title-main">Baby furniture</span> Furniture created for babies

Baby furniture refers to furniture created for babies. It is often used to help the parents of the baby keep it safe and comfortable in the home. Before baby furniture, parents would sleep with their children in their own beds, which could be dangerous for the child. Eventually, infant beds started to be built with the child's safety in mind; the intention was to keep the baby from rolling off the bed, so mangers and bassinets were created. Over time, more furniture was created with the infant's safety in mind, and there are several types and functionalities of these. Typical pieces include an infant bed, changing table, high chair, playpen, baby walker, and toy chest. Products, features, and costs vary between countries and have changed over time. Safety is of paramount importance.

<span class="mw-page-title-main">Infant clothing</span> Clothing worn by infants

Infant clothing or baby clothing is clothing made for infants. Baby fashion is a social-cultural consumerist practice that encodes in children's fashion the representation of many social features and depicts a system characterized by differences in social class, richness, gender, or ethnicity.

<span class="mw-page-title-main">Maternity package</span> Kit provided to parents who live in Finland

The maternity package, known internationally as the Finnish "baby box," is a kit granted by the Finnish social security institution Kela, to all expectant or adoptive parents who live in Finland or are covered by the Finnish social security system. The package contains children's clothes and other necessary items, such as nappies, bedding, cloth, gauze towels and child-care products. It was first issued in 1938 to parents with a low income, and contained a blanket, crib sheets, diapers, and fabric which parents could use to make clothing for the baby.

<span class="mw-page-title-main">Bedside sleeper</span> Bed for an infant attached to bed in which parent sleeps

A bedside sleeper, also referred to as a sidecar sleeper or bedside bassinet, is a bassinet or baby cot that attaches to the parents' bed, allowing newborns to sleep next to their parents safely. This is a form of safe co-sleeping, and has little risks associated with sudden infant death syndrome, unlike bedsharing. Bedside sleepers are a component of rooming-in, a practice followed in hospitals to keep the baby by the mother's bed, giving her time to establish a stronger bond with her baby.

Infant and toddler safety are those actions and modifications put into place to keep babies and toddlers safe from accidental injury and death. Many accidents, injuries and deaths are preventable.

Newborn care and safety are activities and precautions recommended for new parents or caregivers. It is an educational goal of many hospitals and birthing centers to promote newborn care and safety as parents take their infant home.

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